The present invention relates to a method and apparatus for detecting the presence of caries in teeth and more particularly, to a method and apparatus for detecting the presence of caries in the teeth of a person using visible luminescence.
Dental caries or tooth decay is a very common and well known type of disease which, if not properly treated, results in a breakdown of the hard structures of the teeth. The progress of tooth decay is gradual, starting slowly from the outside at the enamel and then progressing more rapidly in the dentin. It is believed that dental caries are caused primarily by the action of acid-producing bacteria on certain carbohydrates, principally sugar. If detected, dental decay can be treated by removing the decayed area and filling the resulting cavity with silver amalgam or other inert cavity material. If untreated, dental caries can cause the eventual destruction of the tooth as well as infection on abscess of the jawbone.
In the past, dental caries has been detected by two techniques, one by visual inspection and the other through the use of X-rays.
The problem with visual inspection is that it is not always possible to detect the presence of caries by simply looking at the teeth, especially if the caries is very small or in a very early stage or in an area where it cannot be easily seen. On the other hand, although X-rays have proven to be a very effective manner for detecting the presence of caries and other problems or disorders in the teeth and/or gums, the potentially harmful effects of subjecting people to X-ray radiation has become a matter of great concern over the last several years. In particular, the quantitive relationship between low-dose exposure to X-rays and possible harmful effects, such as cancer, is not clearly known.
In view of the possible dangerous effects of X-rays, it would appear that a definite need exists for a new technique for detecting the presence of caries and specifically for a technique which can either eliminate or substantially reduce the necessity of X-ray examinations.
Experiments have been conducted in the past which reveal that teeth luminesce when excited by light. In an article by R. L. Hartles and A. G. Leaver appearing in the 1954 Biochemistry Journal, pp. 632-638, the results of certain experiments performed to determine the luminescent properties of teeth when exposed to ultraviolet radiation are discussed at length. Other known articles dealing with the luminescent properties of teeth when exposed to ultraviolet radiation are an article by K. G. Hoerman and S. A. Mancewicz appearing in the 1964 Oral Biology Journal, Volume 9, pp. 517-534 and an article by K. G. Hoerman and S. A. Mancewicz appearing in the 1964 Oral Biology Journal, Volume 9, pp. 535-544.
In U.S. Pat. No. 2,437,916 to W. F. Greenwald there is described a technique for examining living tissue which involves illuminating the tissue with a beam of light and then measuring the intensity of the reflected light at certain wavelength ranges using a phototube and different colored filters.
In U.S. Pat. No. 3,674,008 to C. C. Johnson there is described an instrument which quantitatively measures optical density of a transilluminated body portion. The instrument comprises a controllable, relatively low-frequency oscillator generating pulses which are applied to a light source through a first expand and delay circuit. A light-conducting source to one side of the body portion and a similar means optically couples another side of the body portion to a light detector. Alternatively, the light source and detector may be placed directly on the body portion. After compensation for ambient light, the output of the detector is coupled to a sample and hold circuit which is triggered by the controllable oscillator through a second expand and delay circuit. The stored signal in the sample and hold circuit is proportional to transmittance and is converted to a visual indication of optical density by a calibrated display means. Methods of using the instrument in diagnosis are discussed, as are further applications to spectrophotometric determinations.
In U.S. Pat. No. 3,963,019 to R. S. Quandt there is described a method and apparatus for detecting changes in body chemistry, for example, glycemia, in which a beam of light is projected into and through the aqueous humor of the patients's eye. An analyzer positioned to detect the beam on its exit from the patient's eye compares the effect the aqueous humor has on said beam against a norm. An excess or deficiency of glucose present in the aqueous humor produces a corresponding positive or negative variation in the exiting beam and thereby indicates a hyper or hypo glycemia condition in the body chemistry of the patent being tested.
In U.S. Pat. No. 4,029,085 to D. P. DeWitt et al there is described a method for determining the bilirubin concentration in the blood serum of a person from measurement of the spectral reflectance of the skin. The disclosed method detects the severity of jaundice, a common neonatal conditon, and enables determination of the type of treatment regimen needed to prevent the bilirubin level from becoming sufficiently high to cause kernicterus which can result in brain damage. The method includes measuring the reflectance of the skin within a predetermined frequency spectrum, and more particularly, at a number of specific wavelengths in the visible portion of the spectrum.
In Medical and Biological engineering, Volume 6, No. 4, August 1968, pp. 409-413, there is described a technique for tissue identification during needle puncture by reflection spectrophotometry.